So, in the first Oral Hygiene (OH) article I covered a complete home care routine, but I would like to go into more detail on the importance of cleaning the spaces between teeth where the toothbrush cannot reach.
The majority of people who come to see a dental professional will be brushing daily, maybe not the twice a day that we would recommend but at least once. However, it is also true that most are not in the habit of cleaning in between their teeth and do not believe that is something they need to do. The most held belief is that flossing / interdental brushing is for other people, not them! We will look at the facts and then it will become clear why it is such an important part of a daily OH routine.
Brushing whether with a manual or an electric brush will only clean around 70% of the tooth surfaces (the sides and the tops of the teeth used for biting or chewing ) So approximately 30% of the surfaces i.e. the between-teeth -areas are not being cleaned, if only a toothbrush is used. This does not sound too significant, but if I was to say that missing 30% is the equivalent surface area of not brushing around nine or ten of your teeth (If you had the full 32 teeth present) then that would put it into perspective and you would not dream of missing nine teeth out every time you were brushing!
As discussed in the previous article, what you are removing is sticky bacterial plaque not simply food particles that have got lodged in between the teeth, which is the widest held belief. It is this Dental Plaque that causes tooth decay and gum disease.
So often a person will be unaware of the presence of gum bleeding until told by a Dental Professional because the disease is chronic (Progresses slowly and quietly as opposed to acute where there will be pain. There are acute forms of gum disease, but the chronic ones are seen far more often.) I often hear "My gums only bleed when you prod (!) them!" When we "Prod " ( We prefer "Probe") we are using a blunt explorer or probe which will not damage the gum fibres but will show up weakness in the gums caused by the fibres that bind them to the teeth becoming damaged by the bacterial plaque which is not being removed thoroughly. Hence why they bleed in some areas and not others which have been cleaned properly. (Front teeth usually get most attention), Unfortunately, if you do not also clean between the back teeth no one else will! If this continues the damaged fibres detach from the teeth and the disease progresses deeper into the gums, eventually damaging the bone in which the teeth sit, causing the teeth to loosen.
The most common cause of halitosis (Malodour or bad breath) is lack of regular and thorough cleaning of the spaces between teeth and is almost never down to gastric (Stomach) problems, another common misconception. The malodour is caused by the volatile sulphur compounds produced by the dead and dying bacterial cells in our mouths. This can be rectified by a regular effective Oral Hygiene routine carried out twice daily using a toothbrush AND the correct interdental brushes /Dental tape or floss which removes the food particles and any plaque that has formed between the teeth during the day from eating and overnight. Of course, eating garlic / onions will cause a transient malodour but this passes quickly and is not the sort of chronic halitosis I am describing here.
The usual sign that a person has gum disease is bleeding gums, normally on brushing but sometimes on biting into a crunchy fibrous food or occasionally seen on the pillow in the mornings on waking. Gums do not generally bleed because of brushing too hard (They will however be sore and will recede, not something anyone wants!) If the gums are bleeding, this is due to plaque not being removed sufficiently well from all surfaces. Gums can be helped to heal by a good daily Oral Hygiene regime of cleaning between all teeth with correctly sized interdental brushes and floss /tape and brushing twice a day with a good quality medium (Small headed) nylon bristle manual tooth brush or Electric toothbrush and Fluoride toothpaste.
If caught early enough some forms of gum disease can be reversed through good Oral Hygiene but more advanced disease will need the help of your Dental Professional.
So I'd like to leave you with a phrase I have used over the years (Source Unknown ) "You don't have to floss all of your teeth every day, only those you'd like to keep!)
Thanks to Angie, our hygienist for great article.
Page last updated 09/07/20